A project of the Galen Institute

Issue: "Medicaid"

Study: States Embracing Obamacare See Biggest Drops in Uninsured

Stephanie Armour
Wed, 2014-08-06
"Some states that expanded Medicaid under the Affordable Care Act and set up all or part of their own insurance exchanges have seen a marked drop in the number of uninsured adults. The uninsured rates in states that opted to expand Medicaid, a health program primarily for low-income residents, and set up their own exchanges declined more in the first half of 2014 than in the states that didn’t take that approach, according to a study released Tuesday by Gallup. The survey was based on a random sample of adults through June 30. Arkansas saw the percentage of uninsured drop from 22.5% in 2013 to 12.4% through midyear 2014, according to the survey. Kentucky followed, with its percentage of uninsured dropping from 20.4% to 11.9% during the same time span. The other states with the largest drop in the percentage of uninsured were Delaware, Washington, Colorado, West Virginia, Oregon, California, New Mexico and Connecticut."

My Experience With Medicaid

By Jason Fodeman, M.D.
Thu, 2014-07-31
"The Affordable Care Act may be the law of the land, but some states are still doing their best to avoid it. Nearly half the states have refused to participate in the law’s expansion of Medicaid. Some describe this reluctance as tantamount to a moral crime—see Virginia Governor Terry McAuliffe’s recent statement that expansion’s opponents are “prevent[ing] their own constituents from getting access to health care.” As a doctor, I know this isn’t true. Medicaid is sold to the public as a magic pill that will solve the poor’s inadequate access to medical care. But reality isn’t so simple. Simply put, Medicaid gives patients terrible access to medical care. A recent study found that nearly a third of doctors no longer accept new Medicaid patients. In some states, as many as 60 percent don’t. Why not? Because Medicaid operates in a world without economic logic. Bureaucrats in Washington dictate how much money doctors receive for the treatments and services they provide.

California Releases Proposal For Clearing Medicaid Backlog

Helen Shen, Kaiser News Service
Wed, 2014-07-16
""Responding to inquiries from federal officials, the California health department has released a plan it says will dramatically slash its backlog of Medi-Cal applications within six weeks. For months, the state has labored under the largest such pile-up in the country, with 900,000 pending cases reported in May—the combined result of unexpectedly high application numbers and bug-ridden computer systems. In a letter to the Centers for Medicare & Medicaid Services on Monday, the California Department of Health Care Services said that it had reduced its application backlog to 600,000 by the start of this month. State officials also outlined a plan for technology fixes and administrative workarounds that they project will nearly halve that figure by the end of August—with most of those applications being processed within the allowed 45-day window. The letter was made public Tuesday."

Three Conservative Ideas Buried Within Obamacare

Greg Scandlen, The Federalist
Tue, 2014-07-15
"The Affordable Care Act is the worst piece of legislation ever passed into law in the United States. It was poorly conceived, poorly written, poorly enacted, and is being poorly implemented. The thing is a mess. However, it does open up some doors that were firmly locked before—things that most free-market economists have been espousing for years without success. We should not run away from those things just because they have President Obama’s name on it. I am not talking about the things the idiot media think are popular—the slacker mandate, open enrollment, equal premiums for men and women, and free “preventative” services. These are all terrible ideas for reasons I won’t go into here (unless you insist). I’m talking specifically about several more important elements of the law that were not well crafted in this particular bill, but can now be used as precedents for major improvements in American health care."

What We Learned About Obamacare July 8-14, 2014

Natalie Scholl, American Enterprise Institute
Tue, 2014-07-15
"1.) AEI’s Joseph Antos and James Capretta present “A health reform framework: Breaking out of the Medicaid model.” Here’s a peek: The Congressional Budget Office (CBO) projects that about one-third of the additional insurance coverage expected to occur because of the law will come from expansion of the existing, unreformed Medicaid program. The rest of the coverage expansion will come from enrolling millions of people into subsidized insurance offerings on the ACA exchanges — offerings that have strong similarities to Medicaid insurance. Unfortunately, ample evidence demonstrates that this kind of insurance model leaves the poor and lower-income households with inadequate access to health care…. 2.) “Some still lack coverage under health law,” notes The Wall Street Journal: Months after the sign-up deadline, thousands of Americans who purchased health insurance through the Affordable Care Act still don’t have coverage due to problems in enrollment systems.

What’s Trending in Health Care? Conservative Ideas.

Drew Altman in Wall Street Journal
Tue, 2014-07-15
"Conservative criticism of the Affordable Care Act has created the impression that liberal, “big government” ideas are driving the health-care system. But plenty of ideas that conservatives like are taking hold in health care as well. To wit: *The number of Medicare beneficiaries in private Medicare Advantage plans reached nearly 16 million this year, a record, and the Congressional Budget Office projects that it will hit 22 million by 2020. This partial privatization of Medicare is happening despite concerns that reductions in payments to private plans (what some call over-payments) would curtail enrollment. *More than half of people on Medicaid are enrolled in managed-care plans, which are typically run by private insurers that contract with states on a capitated, or risk, basis. More than 30 million low-income Medicaid beneficiaries are in private plans.

Medicaid Adds Another Million Enrollees in May

Chris Kardish, Governing magazine
Mon, 2014-07-14
"While enrollment in private health insurance through online marketplaces may be closed until Nov. 15, Medicaid and the Children’s Health Insurance Program added almost a million new patients in May, according to the Centers for Medicare and Medicaid Services. Between April and May 928,628 people signed up for Medicaid or CHIP across the 48 states that reported data, up from 805,038 who joined in April but down from the 1.4 million who joined in March. The May figures, released Friday, bring total enrollment to nearly 66 million. Medicaid is jointly funded by states and the federal government to serve low-income children, parents, the elderly and disabled people. The program was expanded through the Affordable Care Act to childless adults earning up to about $15,856 for a single household, though states can choose whether to expand. Twenty-six states and the District of Columbia have done so.

A Health Reform Framework: Breaking Out Of The Medicaid Model

James Capretta and Joseph Antos
Thu, 2014-07-10
"A primary aim of the Patient Protection and Affordable Care Act (ACA) is to expand insurance coverage, especially among households with lower incomes. The Congressional Budget Office (CBO) projects that about one-third of the additional insurance coverage expected to occur because of the law will come from expansion of the existing, unreformed Medicaid program. The rest of the coverage expansion will come from enrolling millions of people into subsidized insurance offerings on the ACA exchanges — offerings that have strong similarities to Medicaid insurance. Unfortunately, ample evidence demonstrates that this kind of insurance model leaves the poor and lower-income households with inadequate access to health care.

Feds Demand Medicaid Backlog Fixes By Six States

Phil Galewitz, Kaiser Health News
Thu, 2014-07-10
"Tired of waiting for states to reduce their backlogs of Medicaid applications, the Obama administration has given six states until Monday to submit plans to resolve issues that have prevented more than 1 million low-income or disabled people from getting health coverage. The targeted states are Alaska, California, Kansas, Michigan, Missouri and Tennessee. “CMS is asking several state Medicaid agencies to provide updated mitigation plans to address gaps that exist in their eligibility and enrollment systems to ensure timely processing of applications and access to coverage for eligible people,” said Aaron Albright, a spokesman for the Centers for Medicare & Medicaid Services. He said the agency will monitor states’ progress in solving the problems getting people enrolled in the state-federal insurance program for the poor."

New York's Health Insurance Exchange: Don't Pop the Champagne Quite Yet

Paul Howard and Yevgeniy Feyman, Forbes
Thu, 2014-07-03
"Obamacare advocates in New York have had good reason to celebrate. In contrast to Oregon’s and other state-based exchanges, New York’s exchange rollout was a relatively smooth, successful affair. Indeed by the time open enrollment closed, nearly 1 million enrollees were notched— split between Medicaid (525,000) and private health insurance (370,000). Moreover, state officials estimate that some 80% of enrollees were previously uninsured. Now for some cold water: New York still has a long way to go. While the state surpassed its first-year goal, total enrollment remains only around 30% of the total eligible population. Moreover, New York State’s Medicaid program, already among the nation’s largest and most expensive, just grew by 10%. And 87% of the new Medicaid enrollees were eligible under New York’s generous, old rules. This means the state will be picking up 50% of the cost for much of this population—not the 10% headline rate for the newly eligible, childless adult population.

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